Information Collection

Supplemental Youth Services Program Report (ETA 9085)

IC 45442 under ICR 201912-1205-009 · OMB 1205-0422.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA-9085 Supplemental Youth Services Program Report (ETA 9085)	Form
ETA-9085 INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-A ETA Form 9085.pdf	Form
ETA-9085 INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-A ETA Form 9085 and Instructions.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 683.300 20 CFR 684

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA-9085	INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-ANNUAL REPORT	ETA Form 9085.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9085	INDIAN AND NATIVE AMERICAN YOUTH PROGRAM ANNUAL / SEMI-ANNUAL REPORT	ETA Form 9085 and Instructions.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOL/ETA-15

FR Citation: 67 FR 16898

Number of Respondents: 73

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	146	-178	324
Annual IC Time Burden (Hours)	292	-7,484	7,776
Annual IC Cost Burden (Dollars)	15,085	15,085	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.